| NPI | 1679590293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-076080) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 60246850) |
| 207P00000X Emergency Medicine (Licence: MO 2009006321) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-01-13 |